Healthcare Provider Details

I. General information

NPI: 1326232331
Provider Name (Legal Business Name): JESS GREGORY BRITO MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2007
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 SILICON VALLEY BLVD
SAN JOSE CA
95138-1858
US

IV. Provider business mailing address

277 N TEMPLE DR
MILPITAS CA
95035-4755
US

V. Phone/Fax

Practice location:
  • Phone: 408-284-9010
  • Fax: 408-284-9048
Mailing address:
  • Phone: 408-942-7396
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: